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119 Cards in this Set
- Front
- Back
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ACE Inhibitors
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Captopril, Enalapril, Lisinopril, Ramipril, Quinapril, Fosinopril
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Angiotensin receptor blockers (ARBs)
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Losartan, Candensartan, Valsartan, etc...
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Beta blockers
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Atenolol, Acebutolol, Bisoprolol, Carvedilol, Metoprolol, Carteolol, Labetalol, Propranolol, Esmolol, Pindolol, Penbutolol, Timolol, etc etc...
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Management of acute angle glaucoma
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Diamox 500mg IV, osmotic diurectics (Mannitol, glycerol), laser peripheral iridectomy
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Thiazide diuretics
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Hydrochlorothiazide, Chlorothiazide, Chlorthalidone, Indapamide, Metolazone
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Loop diuretics
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Furosemide, Bumetanide, Torsemide, Ethacrynic acid
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Aldosterone antagonists
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Spironolactone
Eplerenone |
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Class IA antiarrhythmics
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Quinidine, Procainamide, Disopyramide
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Class IB antiarrhythmics
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Lidocaine, mexiletine and tocainide
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Class IC antiarrhythmics
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Flecainide and Propafenone
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Class II antiarrhythmics
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Beta blockers. Mainly Propranolol, metoprolol (most commonly used) and esmolol (IV for emergency).
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Alpha1 agonists
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Phenylephrine (oral decongestant),
Methoxamine (treatment of hypotension) Metaraminol (hypotension of anesthesia) Midodrine (Symptomatic orthostatic hypotension) |
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Alpha1 antagonists
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Prazosin (Hypertension)
Terazosin (Hypertension, BPH) Doxazosin (Hypertension, BPH) Tamsulosin (BPH) Alfuzosin (BPH) Tolazoline (Vasospastic disorders, pulmonary hypertension in newborns) |
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Alpha2 agonists
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Clonidine (Hypertension, opioid and alcohol withdrawal, GH deficiency test, Panic disorders)
Methyldopa (Gestational hypertension) Methylnorepinephrine (Decongestant) Apraclonidine (Glaucoma) Brimonidine (Glaucoma) |
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Alpha2 antagonists
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Yohimbine (sexual potency improvement)
Mirtazapine |
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Alpha 1&2 agonists
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Many of the alpha1 and alpha2 selective agonists lose their selectivity at high doses. So phenylephrine, etc may stimulate both.
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Alpha 1&2 antagonists
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Phenoxybenzamine (noncompetitive)
Phentolamine (competitive) |
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Beta1 agonists
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Dobutamine (Cardiac emergencies)
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Beta1 antagonists
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The cardioselective beta blockers:
Acebutolol Atenolol Betaxolol Bisoprolol Celiprolol Esmolol Metoprolol Nebivolol |
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Beta2 agonists
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Short acting:
Terbutaline, Albuterol, Salbutamol, Metaproterenol, Ritodrine (stop premature labour), Pirbuterol, Fenoterol Long acting: Salmeterol, Formoterol , Bambuterol, Clenbuterol Ultra-long (once a day dose): Indacaterol All used for bronchoconstriction (treatment of asthma) |
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Beta2 antagonists
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Butaxamine
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Beta 1&2 agonists
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Isoproterenol (Cardiac emergencies and brochoconstriction)
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Beta 1&2 antagonists
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Alprenolol
Bucindolol Carteolol Nadolol Penbutolol Pindolol Propranolol Timolol |
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alpha1, beta1 and beta2 antagonists
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Labetalol (Hypertension), Carvedilol
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alpha1, alpha2, beta1 agonists
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Norepinephrine
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beta1, beta2, alpha1 and alpha2 agonists
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Epinephrine
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beta1, beta2, alpha1, alpha2, dopa1,2,3,4,5 agonists
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Dopamine
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Ganglionic blockers
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Hexamethonium, Nicotine (at high doses), Pentolinium, mecamylamine, trimetaphan, and pempidine
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Sorry this information doesn't concern drugs but includes memorization as well: What are the adrenergic receptors of the eye and what is the effect of their stimulation?
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Radial muscle of the iris: alpha1: mydriasis
Ciliary muscle: Beta2: relaxation |
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Again, what are the adrenergic receptors on the uterus and what does their stimulation cause?
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alpha1: contraction
beta2: relaxation (so e.g. terbutaline could be used to stop premature labour) |
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Mucolytics (and MOA)
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Acetylcysteine, Carbocysteine and Bromhexine
(They cointain free sulfhydryl groups which open dissulfide bonds in the mucus and make it less viscid) |
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Antitussive opioids
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Codeine
Dextromethorphan (D-isomer of codeine) Pholcodine (Tramadol) |
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Expectorants (and MOA)
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Guaifenesin, ipecacuanha, creosotes and volatile oils.
(They incr. the effectiveness of cough by incr. bronchial secretions. Supposedly!) |
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Respiratory stimulators + indications
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Doxapram (used in ICU for respiratory failure, for example overdose of buprenorphine which is not responsive to naloxone)
Aminophylline |
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Pulmonary surfactants
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Synthetic phospholipids:
colfosceril palmitate, poractant alpha, beractant |
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Bronchodilators + (MOA)
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Theophylline, aminophylline (PDE inhib. -> incr. cAMP)
Salbutamol, Terbutaline, Fenoterol, Pirbuterol, Metaproterenol, Ritodrine, Salmeterol, Formoterol, Bambuterol, Clenbuterol, and ultralog acting indacaterol. (Beta2 stim. -> incr. cAMP) Ipratropium, Tiotropium (Inhib. musc. Ach. rec. -> decr. IP3 -> decr. Ca++) |
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Corticosteroids for asthma + route of adm.
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Beclomethasone (inhalation)
Budesonide (inhalation) Fluticonasone (inhalation) Prednisolone (oral) Hydrocortisone (I.V in acute severe asthma) |
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Other antiasthmatics + MOA
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Cromoglycate (Cromolyn) and Nedocromil sodium (Unknow MOA but are used prophylactically and seem to inhibit inflammatory response in allergic asthma)
Omalizumab (binds to IgE so it cant bind to mast cells) Ketotifen (H1 rec. antagonist with possible use in asthma) |
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Drugs of choice for Mild asthma
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The Beta2 agonists for quick relief
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Drugs of choice for moderate to severe asthma
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The Beta2 agonists+
Corticosteroids Long acting Beta2 agonists Possibly Xanthines (theophylline) Other agents if needed |
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Other antiasthmatics + MOA
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Cromoglycate (Cromolyn) and Nedocromil sodium (Unknow MOA but are used prophylactically and seem to inhibit inflammatory response in allergic asthma)
Omalizumab (binds to IgE so it cant bind to mast cells) Ketotifen (H1 rec. antagonist with possible use in asthma) |
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Drugs of choice for Mild asthma
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The Beta2 agonists for quick relief
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Drugs of choice for moderate to severe asthma
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The Beta2 agonists+
Corticosteroids (200-800microg daily) Long acting Beta2 agonists Possibly Xanthines (theophylline) Other agents if needed |
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Agents for COPD
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Inhaled anticholinergics (ipratropium and tiotropium) and Beta2 agonists
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Osmotic diuretics
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Mannitol
Urea Isosorbide Glycerin |
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NSAIDS, Propionic acid derivatives
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Fenoprofen, Flurbiprofen, Ketoprofen, Ibuprofen, Naproxen, Oxaprozin
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NSAIDS, Acetic acid derivatives
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Diclofenac, Ketorolac, Etodolac, Indomethacin, Sulindac and Tolmetin
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NSAIDS Fenamates
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Meclofenamate
Meclofenamic acid |
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NSAIDS Oxicams
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Piroxicam
Meloxicam |
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NSAIDS Salicylates
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Aspirin
Diflusinal |
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NSAIDS selective COX-2 inhibitors
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Celecoxib, Valdecoxib, Rofecoxib, Lumiracoxib. All but Celecoxib are withdrawn from the market, at least in the US.
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Barbiturates (DOA)
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Phenobarbital (long acting)
Pentobarbital (short-acting) Mephobarbital Thiopenthal (ultra-short) Allobarbital Amobarbital Aprobarbital |
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Non-BZDs or Barb. anxiolytic or hypotics
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Buspirone (5-HT1a partial agonism)
Hydroxyzine, diphenhydramine and doxylamine (antihistaminics with anticholinergic sedation) Antidepressants of many kinds Zolpidem, Zaleplon and Eszopiclone Ramelteon (Melatonin agonist) Chloral hydrate (Sedative and hypnotic used in institutionalized patients) Ethanol |
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Methylxanthines
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Caffeine, Theobromine and Theophylline
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Preanesthetics - Groups + (reasoning)
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Anticholinergics (For amnesia and prevention of bradycardia)
Antiemetics (red. risk of gastric aspiration) Antihistamines (For prevention of allergic reactions) Barbiturates (sedation) Benzodiazepines (Amnesia and anxiety reduction) Muscle relaxants (For reduction of reflex tonicity) Opioids (analgesia) |
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Inhalation anesthetics
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Halothane
Enflurane Isoflurane Desflurane Sevoflurane Nitrous oxide |
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Inhaled anesthetics mnemonic
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INHALED + S:
Isoflurane Nitrous oxide Halothane a l Enflurane Desflurane Sevoflurane |
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Intravenous anesthetics
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Barbiturates - Thiopental and Methohexital
Benzodiazepnes - Midazolam & Diazepam Opioids - Fentanyl and derivatives Propofol Ketamine Etomidate |
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SSRIs
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Citalopram
Escitalopram Fluoxetine Fluvoxamine Paroxetine Sertraline |
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SNRIs
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Venlafaxine
Duloxetine |
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TCAs
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Tertiary amines (High 5-HT affinity):
Imipramine Clomipramine Amitriptyline Trimipramine Doxepin Secondary amines (High NE selectivity): Nortriptyline Protripyline Desipramine Tetracyclics: Maprotiline Amoxapine |
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MAOIs
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Phenelzine
Tranylcypromine Selegiline (Type B selective) |
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Atypical antidepressants
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Bupropion
Mirtazapine Nefazodone Trazodone |
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Mania drugs
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Lithium salts
Antiepileptics such as: Carbamazepine, Valproate and Lamotrigine |
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Drugs used to treat neuropathic pain
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TCAs, SNRIs, Pregabalin and Gabapentin (anticonvulsants). In trigeminal neuralgia carbamazepine and lamotrigine may be effective.
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Typical neuroleptics - Groups
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1. Phenothiazines
2. Butyrophenones 3. Thioxanthines |
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Phenothiazines - Subgroups
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1. Aliphatic
2. Piperidines 3. Piperazines |
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Aliphatic phenothiazines
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Chlorpromazine
Trifloupromazine |
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Phenothiazine Piperidines
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Thioridazine
Piperacetazine Mesoridazine |
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Phenothiazines Piperazines
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Fluphenazine
Perfenazine Acetophenazine Carphenazine Procholperazine Triflouperazine |
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Thioxanthines
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Thiothixene
Chlorprothixene |
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Butyrophenones
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Haloperidol
Droperidol |
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Atypical/new neuroleptics
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Aripiprazole
Clozapine Quetiapine Risperidone Ziprasidone Pimozide Molindone Loxapine Olanzapine Sertindole Olindone Paliperidone |
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Pregnancy category X drugs.
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Aminopterin
Dienestrol Diethylstilbestrol Dihydrotestosterone Disulfiram Ergotamine Estrogens Gaseous anethetics (Halothane) Iodine 131 Isotretinoin Methyltestosterone Misoprostol Progestins Quinine Thalidonide Trimethadione |
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Other known teratogens (category)
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ACE Inhibitors (D)
Aspirin (D) Busulfan (D) Cigarettes Cocaine (C) Warfarin (D) Cyclophosphamide (D) Lithium Mercury, organic Methimazole (D) Methotrexate (D) Methylene blue Penicillamine (D) Phenytoin (D) Tetracyclines (D) Toluene Valproate (D) |
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Examples of drug interactions with drugs that act in similar manners.
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Beta-blockers/verapamil/amiodarone/digoxin
ACEIs/K+-sparing-loosing diuretics Alcohol/CNS depressants CNS depressants/CNS depressants Anticholinergics/anticholinergics Nitrates/Sildenafil Methotrexate/Co-trimoxazole Serotonin syndrome Different brand names of same drug (acetaminophen) |
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Examples of drugs which enhance the depressant effect of alcohol.
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Benzodiazepines
Barbiturates Narcotics (opioids) Antihistamines Anticonvulsants Neuroleptics Clonidine Diphenoxylate Antidepressants Anticholinergics |
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Examples of drug interactions with drugs that act in OPPOSING manners.
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NSAIDs/Antihypertensives
Diuretics/hypoglycemics Beta-blockers/Beta-agonists CNS depressants/CNS stimulants (caffeine) Warfarin/Vit. K Lithium/NSAIDs |
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Examples of drug interactions with drugs that act in similar manners.
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Beta-blockers/verapamil/amiodarone/digoxin
ACEIs/K+-sparing-loosing diuretics Alcohol/CNS depressants CNS depressants/CNS depressants Anticholinergics/anticholinergics Nitrates/Sildenafil Methotrexate/Co-trimoxazole Serotonin syndrome Different brand names of same drug (acetaminophen) |
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Examples of drugs which enhance the depressant effect of alcohol.
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Benzodiazepines
Barbiturates Narcotics (opioids) Antihistamines Anticonvulsants Neuroleptics Clonidine Diphenoxylate Antidepressants Anticholinergics |
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Examples of drug interactions with drugs that act in OPPOSING manners.
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NSAIDs/Antihypertensives
Diuretics/hypoglycemics Beta-blockers/Beta-agonists CNS depressants/CNS stimulants (caffeine) Warfarin/Vit. K Lithium/NSAIDs |
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Combinations of drugs that alter the electrolyte balance.
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Diuretics/Digoxin
Lithium/NSAIDs/Sodium intake ACEIs/ARBs/K-loosing,K-sparing diuretics/K-supplements NSAIDs/Antihypertensives |
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Drugs which require monitoring for drug interactions:
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Antiarrhythmics
Anticonvulsants Oral antidiabetics Cyclosporin/tacrolimus Cytotoxics Digoxin Aminoglycosides Heparin Lithium Antidepressants Theophylline Verapamil Warfarin |
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Drugs which cannot be absorbed with charcoal.
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Acids
Alcohols Cyanide DDT Organic solvents Iron salts Glycols (ethylene glycol) Lead salts Mercury salts Lithium salts |
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Drugs used in opiate withdrawal
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Methadone
Buprenorphine Clonidine Lofexidine (like clonidine without hypotension) Naltrexone |
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Hallucinogens
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Lysergic acid diethylamide (LSD)
Mescaline Psilocybin Phencyclidine (PCP) |
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Direct vasodilators
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Hydralazine, dihydralazine
Sodium nitroprusside Nitroglycerin Minoxidil Diazoxid |
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Muscle relaxants used in anesthesia
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Pancuronium
Rocuronium Atracurium Cisatracurium Doxacurium Vecuronium Mevacurium Succinylcholine (may cause malignant hyperthermia) |
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Vit. A derivatives used in dermatology (indication)
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Topical:
Tretionoin (acne) Acitretin for psoriasis Systemic: Isotretinoin (severe acne) Etretinate |
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Vit. K different forms
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K1, Phylloquinone, only natural one
K2, Menaquinone (synth. by GI bacteria) K3, Menadione |
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Vitamin B1
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Thiamine
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Vitamin B2
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Riboflavin
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Vitamin B6
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Pyridoxin
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Vitamin B6 antagonists
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Isoniazid, penicillamine, cycloserine, hydralazine
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Vitamin B12
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Cobalamin
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Vitamin B3
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Niacin
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Vit. B3 (niacin) deficiency
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Pellagra, the 3 D's: Dermatitis, Diarrhea, Dementia
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Vit. B9
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Folic acid
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Vit. B7
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Biotin
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Vit. B5
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Pantothenic acid
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Alcohols causing poisoning (+treatment)
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Methanol (causes acidosis and blindness, and is treated with first bicarbonate, and then addition of ethanol)
Isopropyl alcohol (only dialysis) Ethylene glycol, forming oxalic acid (Gastric lavage, Bcarbonate, Methylene blue, and ethanol) |
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What do we give to patients with hemorrhagic hypovolemic shock?
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Blood
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In nonhemorrhagic hypovolemic shock (for ex. dehydration)
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Crystalloid volume expander or
Colloid volume expanders |
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Constituents of crystalloid volume expanders
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Saline, glucose and sodium chloride which can pass biological membranes.
(rapidly expands both extra and intracellular compartments) Requires very large volumes |
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Constituents of colloid volume expanders
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Large molecules such as albumin, dextrans, gelatins, hetastarch.
They cause osmotic pull into the intravascular space. They however carry the risk of hypersensitivity reaction. |
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Nevertheless, which is the preferred agent in nonhemorrhagic hypovolemic shock?
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Saline
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What are requirements for adm. of vasopressors?
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SBP drop of more than 30mmHg
or MAP less than 60mmHg or end-organ damage occurs due to hypoperfusion. Hypovolemia has to be corrected first. |
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Four nonadrenergic vasopressors that may be helpful during the treatment of shock.
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Vasopressin and Terlipressin have been shown to decrease mortality when used together with vasopressors.
Phosphodiesterase inhibitors (amrinone and milrinone) They are however vasodilatatory but positively inotropic. Nitric oxide synthase inhibitors, because vasodilation due to septic shock is believed to be caused by prod. of NO. |
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Anticoagulant used in septic shock which is also used in DIC.
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Drotrecogin alpha (synthetic Protein C which degrades coagulation factor V to VIII we use it because microvascular coagulation is one factor causing organ damage in septic shock)
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Mediators of septic shock
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LPS (endotoxin) from the membranes of G- bacteria.
IL-1, IL-6, TNF-alpha Cascade of other inflammatory mediators. |
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Inotropic agent used in anaphylactic shock in patients who are on beta blockers?
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Glucagon
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Antinflammatory agent we use in anaphylactic shock and dosage.
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Hydrocortisone, 100mg I.V every 6 hours.
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Antiplatelet drugs (MOA)
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Aspirin (Inhib. form. of TXA2)
Clopidogrel (Blocks ADP rec.) Ticlopidine (Blocks ADP rec.) Prasugrel (new drug, better tolerated, more effective than ticlopidine and clopidogrel) Abciximab (Blocks GP IIb/IIIa rec.) Eptifibatide (Blocks GP IIb/IIIa rec.) Tirofiban (Blocks GP IIb/IIIa rec.) Dipyridamole (Inhib. PDE and reduces ADP uptake) |
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Anticoagulants (MOA)
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-Heparin (GAGs, binds antithrombin III and reinforces its inactivation of coagulation factors by a 1000-fold, mainly thrombin and Xa)
-LMWH, Enoxaparin (same as heparin, but most Xa degradation) -Lepuridin (direct thrombin antagonist) -Argatroban (direct thrombin inhibitor) -Fondaparinoux (selective inhibitor of Xa via antithrombin III stimulation) -Warfarin (Vit. K antagonist, prevents gamma-carboxyglutamate formation on clotting factors which normally binds calcium) |
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Thrombolytics (MOA)
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Alteplase (converts fibrin-bound "fibrin selective"plasminogen to plasmin, which degrades fibrin)
Streptokinase (converts free plasma plasminogen to plasmin, which degrades fibrin) |
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Drugs used to treat bleeding (MOA)
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Aminocaproic acid and transexamic acid (inhibit plasminogen activation)
Protamine sulphate (binds with heparin and inactivates its action) Vit. K (causes carboxylation of glutamate residues on clotting factors, forming gamma-carboxyglutamate which can bind with ca++ and interact with platelets) Aprotinin (blocks plasmin) |
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LSD related compounds
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Lysergic acid diethylamide (50mcg enough)
Psilocybin Mescaline |
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Drug classes for heart failure and their effect on morbidity/mortality. According to handout.
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Diuretics (unknown effect on mortality, but effective for symptoms)
ACE inhibitors (decr. progression, and decr. mortality) Spironolactone may incr. survival due to decr. cardiac remodelling but shoudn't be combined with ACE inhibitors. |
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Drug classes for heart failure and their effect on morbidity/mortality. According to Lippincott.
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ACE inhibitors significantly reduces morbidity and mortality.
ARBs have unknown effects on mortality in CHF but they do have proven decreased morbidity in hypertension. Beta blockers show improved systolic functioning and reverse cardiac remodelling probably leading to decr. mortality. |
